Analyst - State of MI

Blue Cross Blue Shield of Michigan; Detroit (MI); On-site; USD 60,000 - 85,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking an operations analyst for the State of Michigan account. The analyst will handle member and claim escalations, investigate membership discrepancies, COB inquiries, and Medicare eligibility checks.

You will support project coordination, data analysis, and reporting, and assist with meetings and training to improve customer service levels. Occasional travel may be required.

Qualifications

• Bachelor's Degree in a related field is preferred.
• Two (2) years of experience in a related field is required.
• Effective verbal, written communication and interpersonal skills.
• Ability to work independently or in a team environment and interact with all levels of the organization.
• Effective analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
• Organizational skills and ability to prioritize; must be able to coordinate multiple activities with varying timelines.
• Proficient in Microsoft Office suites.
• Ability to develop and maintain effective working relationships.

Responsibilities

• Respond timely to membership and claim related escalations from customer for Blue Cross or BCN members
• Investigate and resolve membership discrepancies
• Investigate and resolve COB inquiries
• Investigate and resolve Medicare eligibility inquiries
• Assist with presenting at Benefit Open Enrollment and retiree meetings
• Demonstrated ability to function as an engaged and positive ambassador of BCBSM/BCN with attitudinal qualities to service and retain our State of Michigan customer
• Occasional travel is required
• Support the development, coordination, and implementation of projects to enhance the overall efficiency of operational procedures, methods, controls, and performance.
• Compile and analyze operational data to identify and resolve business problems.
• Utilize and maintain available reporting systems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
• Provide leadership team with status updates on projects and issues.
• Communicate and recommend policy changes to achieve project objectives. Assist in documenting departmental procedures.
• Create and present reports and presentations to display operational data and propose business changes.Provide support to both internal departments and external entities by answering questions, supplying information and training.
• Participate on special projects or workgroups as assigned.

Skills

Verbal communication

Written communication

Interpersonal skills

Analytical thinking

Organizational skills

Education

Bachelor's degree in related field

Bachelor's degree preferred

Tools

Microsoft Office Suite

Job description

Department Summary

This position is dedicated to the State of Michigan account. The analyst responsibilities will include:

• Respond timely to membership and claim related escalations from customer for Blue Cross or BCN members
• Investigate and resolve membership discrepancies
• Investigate and resolve COB inquiries
• Investigate and resolve Medicare eligibility inquiries
• Assist with presenting at Benefit Open Enrollment and retiree meetings
• Demonstrated ability to function as an engaged and positive ambassador of BCBSM/BCN with attitudinal qualities to service and retain our State of Michigan customer
• Occasional travel is required

Department Preferences

• Bachelor’s degree preferred
• Three years’ customer service and/or membership experience preferably in the State of Michigan department with state benefits knowledge
• Working knowledge and experience in NCOMPASS/MEMBERSEDGE/FACETS/MARX
• Ability to provide root cause analysis to claims and membership problems
• Strong organizational skills
• Exceptional follow-through abilities
• Demonstrated knowledge and experience implementing innovative process improvements

Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality.

• Support the development, coordination, and implementation of projects to enhance the overall efficiency of operational procedures, methods, controls, and performance.
• Compile and analyze operational data to identify and resolve business problems.
• Utilize and maintain available reporting systems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
• Provide leadership team with status updates on projects and issues.
• Communicate and recommend policy changes to achieve project objectives. Assist in documenting departmental procedures.
• Create and present reports and presentations to display operational data and propose business changes.Provide support to both internal departments and external entities by answering questions, supplying information and training.
• Participate on special projects or workgroups as assigned.

Qualifications

• Bachelor's Degree in a related field is preferred.
• Two (2) years of experience in a related field is required.
• Effective verbal, written communication and interpersonal skills.
• Ability to work independently or in a team environment and interact with all levels of the organization.
• Effective analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
• Organizational skills and ability to prioritize; must be able to coordinate multiple activities with varying timelines.
• Proficient in Microsoft Office suites.
• Ability to develop and maintain effective working relationships.

All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.

Candidates are hired on an "at will" basis. Nothing herein is intended to create a contract.